TheSquire

Five years experience as an FNP, largely in urgent care. I am currently bouncing around the Great Lakes states doing locums in occupational medicine, $90/hr on a 1099 gig, so no benefits. I'm in the process of being credentialed for a locums urgent care gig, same rate but W2, so I won't have to deal with my own withholding, deducting work expenses, etc. I'm currently looking for permanent gigs in the city where I live - I'd be happy with at least $70/hr W2 for urgent care or something adjacent.

That's not how the LACE framework works - after you graduate, in all the states that I'm aware of you then have to apply for and be granted licensure, generally after you are certified in your specialty. Just like graduating from nursing school does not itself make one a nurse in many states, merely graduating from an APRN program does not by itself make you an APRN.

The Urgent Cares that I've worked at generally put full-time at 4 shifts/week. I'm now going to work at an Emergency Department; 120 hours/4 weeks is considered full time by the practice, with shifts being generally 10 or 12 hours long.

Whenever management at my former ED made noises about staff not taking lunches, I'd point out A) properly staffing the unit is their responsibility and B) that I'd never gotten a 15-minute break, let alone two of them, in addition to my lunch break while working there. They'd go quiet for a while after that.

UCC nurses haunt the Ambulatory Care specialty page

My experience is working at BSA Summer camps as a Health Officer, which are a different setting than most Summer camps you'll see discussed here. While the exact situation varies depending on local state laws and regulations regarding Summer camps, in order to work for a Scout camp you'll need to have some sort of completed certification in order to be a Health Officer, although that can be as low as Medical First Responder/Emergency Medical Responder.

I suture (which I did a lab on in school); I also do I&Ds, nail trephination, superficial foreign body removal, and ear irrigation,

I don't know where you're getting "most" from. At least in NJ, "most" Urgent Cares are either mom-and-pops or franchised chains independent from the local hospital groups.

IBCLC is effectively an RN-level certification; it's hefty, to be sure, but it does not grant any Advanced Practice privileges. This seems like someone who has mistaken simile for equivalency.

Many urgent cares don't do IV access/infusion except while waiting on an ambulance to take an acute pt to the ED, so those skills are rarely needed, and often done by the provider.

I took Solheim's class from the man himself back in the before-times and then passed the test a month later, so while I can't comment on the efficacy of the online version, the in person format worked well for me. He's also good at going over the things you might not see in your area, but are on the test. Also, you definitely should sit through your ENPC and TNCC prior to taking the CEN - a lot of the material from those two classes make it onto the exam.

I'm reminded of a scene in Fight Club, and I should bring up that one would have to factor in the increased rate of errors committed by new grads and other new hires and the resultant increase in malpractice settlement payouts, unless that's already included in the $50k/new hire figure.

I graduated from DePaul's DNP/FNP program in November 2018, intending to go into Emergency to initially work Fast Track. I already had a MS in Nursing, so I'd sat the boards after completing the initial clinical curriculum. My problem was that between 2013 when I entered and 2018 when I graduated the employment market saturated and most EM groups wanted experienced APPs to work the main floor. I couldn't even get an Urgent Care job for the better part of a year, since those practices are more bottom-line focused and really don't want to train a completely green new grad. Eventually, I ended up moving to NJ for an Urgent Care position out here; I interviewed in October 2018 and spent the next few months getting my licenses transferred. They paid a bit light, but were willing to hire me on and train. They also turned out to be a bit...hmmm...fly-by-night, and after a year I ended up in a different, better, and better-paying position.

As addressed by others, schools, colleges, and departments of nursing use adjunct positions the way they're intended to be used - to allow a department or school to bring in current practitioners in a field to teach in the classroom and/or supervise on-site learning. Most nursing schools have a bevy of adjuncts which are used for supervising clinical rotations; some states require instructors with faculty rank to supervise lab sections as well. Some schools will have an adjunct teach didactic sections, but if they're doing that they're possibly being auditioned for a non-tenure-track position. Being able to teach multiple classes is one of the better ways to ensure consistently being picked up as an adjunct. I gravitate towards teaching lab myself, either fundamental skills or health assessment, so when the program I first taught for only had 2 cohorts per year, there was always a class I could teach. When they went up to 4 cohorts per year I could pick my favorite class and stick with it, which is when the second strategy to being consistently picked up came into play - I.e., be good at teaching a class other adjuncts don't want to teach, to the point that the program director/course coordinator will slot you in first.

There's a lot to unpack here written by someone who doesn't know what they're talking about, so let's take it from the top. If you're going into nursing specifically to do advanced practice, you're going into the wrong field. If you know that you want to do that, go be a Physician's Assistant. The various advanced practice fields in nursing exist for experienced nurses who decide to go to the next level, not as a quick route from lay person to provider. There is no functional distinction between an MSN and an MS in Nursing; the difference is largely historical, and you can sit boards just the same. My classmates (and students) later matriculated to and graduated from many different post-masters and DNP programs. The MSN-DNP programs that heythatsmybike talks about are properly referred to as DNP-Completion programs...and those require prior advanced practice certification. MENP grads apply to BSN-DNP programs, just like any other baccalaureate-prepared nurses - although I suggest keeping your syllabi to see if you can get out of some grad courses if you matriculate elsewhere. As a graduate of both the MENP and the DNP at DePaul, more than once class transfers over. In fact, for the first year you can go part-time and generally keep pace with the full-time students. DePaul's DNP options are limited, so if you're counting on staying for the DNP you should keep that in mind in case you want to do Acute Care. Graduate School is expensive, but if you go on to pursue additional education in nursing, be it a doctorate or post-master's certificate, the Nurse Practice Act of the State of Illinois requires only requires faculty to have a Master's Degree...which all MENP grads have. I was not unusual in being able to teach my way through my DNP, getting tuition waivers for all the classes I taught. I ended up graduating with no additional debt. Part of the reason for the MENP is that graduate education opens up access to GradPLUS loans, while second bachelors degrees aren't supported by Dept. of ED.-backed loans.

I'm not familiar with said CRNA strife - care to elaborate on what it is and how it's related to having only one certifying body?

Loads of people here forgetting that nursing students for over a decade have had access to social media, including this very forum. They read and have an idea of what they're getting into, the monthly "How do I prep for x unit" posts notwithstanding.

I went into Emergency Nursing not because it was glamorized, but because my prior medical exposure was prehospital, because I like being a jack-of-all-trades, and because I liked being able to leave work at work at the end of my shift. I didn't even know that I could go directly into the ED as a new grad until one of my instructors mentioned that that's what she did. (She was also both an FNP and a CRNA.) At that point, I intentionally made sure I had as much ED exposure as I could get, even doing my immersion experience in the ED. There was no glamour, it was just the kind of nursing I felt would fit me best, and I was right. I feel like threads such as these get started by nurses who are salty that newer nurses "don't have to put in their time" in med/surg prior to going on to a specialty they actually enjoy.

They won't even let you test and then embargo the result until you finish your program? That's a bummer. AANPCB did that for people from my program in our shared situation; but then ANCC plays by their own rules.

The problem is that the school has ZERO control over the situation. All the certification boards have sat down and declared that you MUST complete the program for which you enrolled. They don't care if you "change programs". I guarantee that the school would love to cut OP a post-master's certificate and be done with the matter...but ANCC et al. will just sit on it until they have OP's DNP transcripts in hand. The certifying board may let OP test upon receiving notification that they have a prior master's in nursing and have completed all clinical requirements for the new certification (or, at least, AANPCB will), but even then they will not issue the certification until they have a transcript showing that OP has completed their DNP.

...AANPCB does exist, and covers FNP and AGNP As for the rest of your post, it doesn't address the historical process that led up to how things got to be the way they are today. I'm not yet interested in why, I want to start with how.

How did we end up with multiple certifying boards per NP specialty - with AANPCB covering "adult" roles and PNCB covering "pediatric" roles in competition with ANCC? ANCC doesn't like to post about its own history on its website, and other boards talk about themselves and not why they exist independently. So, I ask the wisdom of the crowd - how did we get here? I'm not interested in why you like one over the other, I just want to know why things are the way they are today.

I re-upped my PALS, and then my BLS/ACLS through an agency in Jersey City. They cap their classes at a super-low level (I think my PALS class had 4 students, and my BLS/ACLS class had only 3 including myself). Personally, I think doing online-only CPR renewal is a bad plan...but then again, many agencies skimp on requirements/feedback, so I'm not sure that I got all the bang for my buck that I should've.

Either OP did not pay attention during their Professional Development class, or OP's school definitely dropped the ball.

I enrolled in my DNP in Fall of 2014; as I was a graduate of the MENP program at DePaul (and thus already had my MS in nursing) the plan I was given by my SON was to finish my FNP-core, they'd issue a post-master's certificate, and then I'd finish out the DNP while starting to work as an FNP. However, sometime in 2015 I was sat down by my program director who told me that the powers-what-is were apparently concerned that people with masters in nursing wouldn't complete the DNP without the carrot of their APN certifications being held in the balance, and so all the major certifying bodies had decided that they would not credential without completing the program. It was 100% total BS - and it reveals the disconnect between the push for the DNP and what the workforce actually wants. The fact that AACN et al. backed down from mandating DNP-as-entry the same year just added salt to the wound. The only small upside was that I was able to sit for boards prior to graduation before all my mental knowledge went stale. And yes, it totally sucked - if I had hit the job market an extra 1.5 years early, I probably would've gotten one of the last ED NP jobs before all the major groups stopped hiring non-ENP new grads. What essentially needs to happen is that those of us in the initial group of DNP-as-entry cohorts need to advance up the ranks of academia and professional associations, and dismantle half of this crap from the inside.